Will AHCA kill people?

As the GOP stumbles through healthcare "reform" with the progression of an AHCA-like bill in the Senate, it is worth considering the Left's argument that these policies could be deadly for thousands of Americans. The argument that AHCA or similar Obamacare-repeal bills would cost lives is a common one. Bernie Sanders tweeted in January that 36,000 more people would die yearly from a repeal of Obamacare, and an analysis at the American Journal of Public Health found that a clean ACA repeal would result in an additional 14,000 to 60,000 deaths in 2018 alone.

Now, this argument makes a lot of sense. Based on pure statistics, if you make it harder for people to access healthcare on a regular basis by taking away their health insurance, the mortality rate will necessarily go up. In addition, the people that would lose health insurance under AHCA are disproportionately poor, old, and sick. AHCA's waivers for community ratings and essential health benefits would price some individuals with pre-existing conditions out of the market in red states that utilized such waivers. In addition, AHCA would pare back the size of subsidies for the poor with its age-based tax credits, and would expand the age-band rating for pricing from 3-1 to 5-1, pricing many elderly individuals out of the market. As such, not only would AHCA remove health insurance from 23 million individuals, but it would remove health insurance from a population that already suffers from worse health outcomes. I can't fathom how removing health insurance from such a precariously-situated population would not have disastrous public health consequences resulting in the death of thousands.

However, this sort of logic has a slippery-slope problem, as Hank Green pointed out on Thursday. If you assign blame to the Republicans for the death of thousands due to AHCA, do you assign blame to politicians for other policies with less obvious repercussions? For example, take the issue of farm subsidies. Every year, the United States pays $20 billion to farmers in the form of direct farm subsidies. Based on our understanding of economics, there is no market imperfection these subsidies are correcting for, and virtually no need for them whatsoever. Imagine that we instead spent our farm subsidy money on various healthcare innovations, such as cancer treatment. Are the politicians that support farm subsidies complicit in the death of cancer patients by withholding funding for their treatment? This seems far-fetched to most, but it's really just a logical extension of the earlier argument against AHCA.

However, we need not abandon this argument, even though it becomes absurd in the extreme. As a society of rational individuals, we must be able to distinguish between vile, immoral political betrayals, and run-of-the-mill policy. To demonstrate this point, let's extend the AHCA-kills-people logic in the other direction. Suppose that Congress was debating whether to pour cyanide into municipal water systems. While this is obviously an extreme example, no one would argue that this is not a vile, murderous policy. To take a more realistic example, suppose that President Trump was considering deploying ground troops in Syria to fight the Islamic State. Arguing that Trump's policies would have deadly results is common sense given the nature of war.

Obviously, these are all hypotheticals, but it's useful to consider the extent to which politics affect real people's lives. While we shouldn't denigrate politicians as murderers for not diverting decades-old farm subsidies towards cancer research, we must consider the deadly results of policies that hinder millions from accessing healthcare. AHCA's potential devastation is more direct, egregious, and predictable than the farm subsidy example, and we must react as such.